1. Beginner’s Technique with SLT
Sungjun Hwang MD
Amy Zhang MD
Financial Disclosure: Hwang Gonio Lens (Ocular Instruments)

2. Purpose
Selective Laser Trabeculoplasty (SLT) difficult for the novice given lack of burn marks
Alternative method using a modified Latina SLT Gonio Laser Lens (Ocular Instruments)

3. Methods 161 SLT procedures Private comprehensive practice
Modified Latina SLT Gonio Laser lens
4 months follow-up
Reflected
Indicator
45o Indicator

4. Methods Latina SLT Gonio Laser Lens
-modified to indicate a 45o arc on the trabecular meshwork
Laser applied to a 90o arc using 45o indicator as a guide
90o Arc
45o Indicator

5. Methods Successively positioned to treat 4 quadrants of each eye
Superior
Lateral
Successively positioned to treat 4 quadrants of each eye
Superior, Temporal inferior and nasal quadrants of trabecular meshwork
Inferior
Lateral

6. Results Average Pressure Difference -2.38 ±4.77
131 out of 161 eyes (81.4%) had reduction in intraocular pressure (IOP)
43 eyes (26.7%) were able to reduce the usage of IOP lowering medications
30 eyes (18.6%) did not experience any IOP reduction
No adverse outcomes were noted

7. Conclusion
Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) are common modalities for treatment of glaucoma with similar efficacies.1,2,3
ALT allows for visualization of the burn marks thus facilitating placement of the next burn mark especially for the novice.4,5
New technique with the modified lens allows similar visualization on the SLT laser and yields good results.

8. References
1. Shingleton BJ, Richter CU, Bellows AR,Hutchinson BT, Glynn RJ
Long-term efficacy of argon laser trabeculoplasty.Ophthalmolog1987 Dec;94(12):
2.McIlraith I, Strasfeld M, Colev G, Hutnik CM Selective laser trabeculoplasty as initial
and adjunctive treatmentfor open-angle glaucoma. J Glaucoma Apr;15(2):
3. Stein JD, Challa P.Mechanisms of action and efficacy of argon laser trabeculoplasty
and selective laser trabeculoplasty. Curr Opin Ophthalmol Mar;18(2):140-5.
4. Pham H, Mansberger S, Brandt JD, Damji K, Ramulu PY, Parrish RK. Argon
Laser trabeculoplasty versus selective laser trabeculoplasty. Surv Ophthalmol Nov
Dec;53(6):641-6.
5. Mahar PS, Jamali KK. Argon laser trabeculoplasty as primary therapy in open angle
glaucoma. J Coll Physicians Surg Pak Feb;18(2):102-4.